| NPI | 1134204662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: TN 54902) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 0106407A) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: MS 23646) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2016-11-18 |