| NPI | 1780207209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: PA MT227740) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP04937) |
| Enumeration Date | 2020-05-19 |
| Last Update Date | 2023-06-21 |