| NPI | 1811491749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: CA A164879) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A164879) |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2025-03-26 |