| NPI | 1962405316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 22318) |
| Additional Taxonomies | 207RI0200X Internal Medicine Infectious Disease (Licence: SC 22318) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2020-10-05 |