| NPI | 1558342675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: WA MD60078032) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60078032) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2019-03-29 |