| NPI | 1114993573 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: VA 0101050092)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101050092)  | 
| Enumeration Date | 2006-02-27 | 
| Last Update Date | 2016-06-08 |