| NPI | 1497719306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: TX P3662) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: KY 48600) |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2018-05-14 |