| NPI | 1972638583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: TX Q1109) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 228892) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2024-08-15 |