| NPI | 1205891686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VT 042.0011900) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 35626) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: VT 042.0011900) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2014-12-04 |