| NPI | 1255369815 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: TX J6480) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX J6480) | 
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: TX J6480) | |
| Enumeration Date | 2006-06-30 | 
| Last Update Date | 2015-01-13 |