| NPI | 1003853912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 11106) |
| Additional Taxonomies | 207RG0300X Internal Medicine Geriatric Medicine (Licence: AZ 11106) |
| 207RI0200X Internal Medicine Infectious Disease (Licence: AZ 11106) | |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2007-07-08 |