| NPI | 1386612976 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: SC 18702) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 18702) | 
| Enumeration Date | 2006-03-09 | 
| Last Update Date | 2018-03-15 |