| NPI | 1083828750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: AZ 45091) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: LA 203365) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2014-10-02 |