| NPI | 1225108772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MN 49959) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.084569) |
| 207R00000X Internal Medicine (Licence: MN 49959) | |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2020-08-13 |