| NPI | 1790084325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01073379A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.016190) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: IN 01073379A) | |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: MI 4301100330) | |
| Enumeration Date | 2011-03-22 |
| Last Update Date | 2018-08-23 |