| NPI | 1154302834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 203894) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: MA 203894) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2012-11-15 |