| NPI | 1811173271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: PA MT192014) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301085970) |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2023-03-28 |