| NPI | 1356343040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS13142) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: CA 20A 10964) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2015-02-18 |