| NPI | 1528065471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: WA MD37221) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: CA A79275) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2019-12-31 |