| NPI | 1104182302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MI 4301500214) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA MD-42452) |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2020-10-07 |