| NPI | 1588897086 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MI 4301105160) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301105160) | 
| Enumeration Date | 2009-08-31 | 
| Last Update Date | 2016-01-27 |