| NPI | 1588749600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A89181) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: CA A89181) |
| 208D00000X General Practice (Licence: CA A89181) | |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2018-04-11 |