| NPI | 1346213618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 47375) |
| Additional Taxonomies | 207RI0200X Internal Medicine Infectious Disease (Licence: MA 47375) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2007-07-08 |