| NPI | 1740548312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: GA 83807) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 83807) |
| Enumeration Date | 2012-05-02 |
| Last Update Date | 2019-10-25 |