| NPI | 1386679561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G22170) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: CA G22170) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2015-04-30 |