| NPI | 1417931700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: IA 34520) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 44565) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2012-05-22 |