| NPI | 1508856287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 74425) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: MA 74425) |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2011-10-11 |