| NPI | 1194761874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301079098) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: MI 4301079098) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2012-04-04 |