| NPI | 1780034363 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL OS16332) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL39785) | 
| Enumeration Date | 2016-06-15 | 
| Last Update Date | 2021-10-21 |