| NPI | 1790755759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine Infectious Disease (Licence: FL ME 70874) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME 70874) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2025-07-28 |