| NPI | 1962848663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0065425) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 59810) |
| 207R00000X Internal Medicine (Licence: VA 0101271098) | |
| 207R00000X Internal Medicine (Licence: MN 58237) | |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: MN 58237) | |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2023-01-10 |