| NPI | 1164597480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: ND 9699) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ND 9699) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME99876) | |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2011-11-30 |