| NPI | 1831543461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: TX T6333) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10056248) |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2022-04-21 |