| NPI | 1922052570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: TX K5101) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME78722) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: KS 0451376) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2026-05-29 |