| NPI | 1568753028 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MN 56792) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 56792) | 
| Enumeration Date | 2011-05-02 | 
| Last Update Date | 2020-01-22 |