| NPI | 1871728741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: CT 61141) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: CA A120617) |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2021-01-26 |