| NPI | 1912495599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: WI 100888875) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.157286) |
| Enumeration Date | 2018-04-29 |
| Last Update Date | 2023-10-26 |