| NPI | 1760625032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: OK 33254) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: MO 2013002759) |
| Enumeration Date | 2009-04-15 |
| Last Update Date | 2018-03-17 |