| NPI | 1700102639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: WA MD60293087) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AK MEDS7910) |
| 207R00000X Internal Medicine (Licence: WA MD60293087) | |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: AK MEDS7910) | |
| Enumeration Date | 2010-04-16 |
| Last Update Date | 2025-05-28 |