| NPI | 1104890813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: RI MD14543) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD421845) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2014-10-03 |