| NPI | 1063850543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MN 64452) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: MA 265066) |
| 207R00000X Internal Medicine (Licence: MA 255586) | |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2018-09-18 |