| NPI | 1689874711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: VA 0101260626) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 047962) |
| 207R00000X Internal Medicine (Licence: WI 50079-020) | |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: WA MD60254430) | |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2023-03-07 |