| NPI | 1689011504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: OR MD176499) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT204623) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: NC 2021-00939) | |
| Enumeration Date | 2013-06-01 |
| Last Update Date | 2024-02-12 |