| NPI | 1740697598 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MN 62025) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.064916) | 
| Enumeration Date | 2014-07-14 | 
| Last Update Date | 2020-08-20 |