| NPI | 1518945658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: CA c54607) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: TN 38871) |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2011-04-19 |