| NPI | 1750366399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: ID M-17781) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: CO 30415) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2024-05-10 |