| NPI | 1013987809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: CO 32544) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO 32544) |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: CO 32544) | |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2015-01-29 |