| NPI | 1770762262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: TX R9056) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.088076) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: OH 35088076) | |
| Enumeration Date | 2007-10-31 |
| Last Update Date | 2019-05-08 |