| NPI | 1104072636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: CO 46695) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO 46695) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: MS 28623) | |
| Enumeration Date | 2008-08-15 |
| Last Update Date | 2021-08-31 |