| NPI | 1407121585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MA 250628) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA L-250628) |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2012-11-30 |