| NPI | 1730819210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MN 79548) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL 36026) |
| Enumeration Date | 2022-06-16 |
| Last Update Date | 2025-05-06 |