| NPI | 1871936997 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MD D92014) | 
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: MA 284392) | 
| Enumeration Date | 2013-04-08 | 
| Last Update Date | 2021-07-27 |