| NPI | 1902062151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20A12692) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: CA 20A12692) |
| Enumeration Date | 2008-08-06 |
| Last Update Date | 2021-11-23 |