| 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 |