| NPI | 1174589147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A50622) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD072558L) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: CA A50622) | |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: PA MD072558L) | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2007-07-08 |