| NPI | 1720375876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: WA MD60913024) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60913024) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: LA 303212) | |
| Enumeration Date | 2011-07-08 |
| Last Update Date | 2019-09-06 |