| NPI | 1437578432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NE 28763) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NE 28763) |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2018-05-01 |