| NPI | 1700404100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: VA 0101289447) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: OH 35.148702) |
| Enumeration Date | 2020-07-12 |
| Last Update Date | 2026-08-07 |