| NPI | 1528015864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: TX M4921) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 17201) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2014-03-25 |