| NPI | 1508085739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: OR MD160501) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: NC 2010-01245) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2012-11-06 |