| NPI | 1043474034 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NH 14786) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NH 14786) | 
| Enumeration Date | 2008-07-18 | 
| Last Update Date | 2013-06-24 |