| NPI | 1821470543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: WA MD61187310) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA ML60939424) |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2021-07-28 |