| NPI | 1174500565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: AZ 5472) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 44468) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: MN 44468) | |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2020-09-09 |