| NPI | 1912967514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MA 203094) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME109448) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: TX TM00991) | |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2022-08-16 |