| NPI | 1205098456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: CA 20A11186) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R70150) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2014-07-07 |