| NPI | 1780675439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: WI 69966) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35089520) |
| 207R00000X Internal Medicine (Licence: WV 21760) | |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2023-10-20 |