| NPI | 1972504314 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD204668) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO DR.0041439) | 
| 207RI0200X Internal Medicine, Infectious Disease (Licence: CO DR.0041439) | |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: OR MD204668) | |
| Enumeration Date | 2005-08-09 | 
| Last Update Date | 2022-01-27 |