| NPI | 1760864888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MO 2017016664) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101021789) |
| 207R00000X Internal Medicine (Licence: MO 2016015544) | |
| 207R00000X Internal Medicine (Licence: MO 2017016664) | |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2023-08-17 |