| NPI | 1164576583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: TX F8813) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX F8813) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2011-06-28 |