| NPI | 1063733392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: OR MD178542) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 244468) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: CA 131304) | |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2016-09-19 |