| NPI | 1073500765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: WA MD61064980) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: NC 9500993) |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2020-09-03 |