| NPI | 1154341055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: AZ 10958) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: CA G25536) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2012-02-10 |