| NPI | 1669647889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: SC 34048) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT186425) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2020-09-10 |