| NPI | 1982760484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: OR MD16674) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: WA MD00037669) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2022-02-04 |