| NPI | 1912162819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 52062) |
| Additional Taxonomies | 207RI0200X Internal Medicine Infectious Disease (Licence: NC 2021-02305) |
| 207RI0200X Internal Medicine Infectious Disease (Licence: VA 0101270716) | |
| 207RI0200X Internal Medicine Infectious Disease (Licence: WV 31189) | |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2024-03-25 |