NPI | 1679197305 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MI 4301509854) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4351046250) |
Enumeration Date | 2020-05-28 |
Last Update Date | 2025-08-04 |