| NPI | 1467726893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: WA 00023008) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: CA G55134) |
| Enumeration Date | 2012-03-02 |
| Last Update Date | 2012-03-02 |