NPI | 1699124347 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: CA 150547) |
Additional Taxonomies | 171000000X Military Health Care Provider |
Enumeration Date | 2016-06-03 |
Last Update Date | 2023-06-21 |