| NPI | 1174708341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MI 4301095237) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT187663) |
| Enumeration Date | 2008-01-07 |
| Last Update Date | 2014-09-26 |