| NPI | 1417947482 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: OK 14704) | 
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: TX F4105) | 
| Enumeration Date | 2005-10-21 | 
| Last Update Date | 2011-06-30 |