| NPI | 1285647115 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MO R4J28) | 
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: CA G37510) | 
| Enumeration Date | 2006-08-14 | 
| Last Update Date | 2021-01-28 |