| NPI | 1306079512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: CA A70171) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: NC 22828) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: HI 15386) | |
| Enumeration Date | 2009-09-03 |
| Last Update Date | 2009-09-03 |