| NPI | 1326272071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A42207) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: CA A42207) |
| 207RS0010X Internal Medicine, Sports Medicine (Licence: CA A42207) | |
| Enumeration Date | 2009-05-11 |
| Last Update Date | 2009-05-11 |