| NPI | 1821020629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2009-00263) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD25254) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: NC 154771) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2022-10-24 |