| NPI | 1609011295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: PR 18236) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 27229) |
| Enumeration Date | 2008-12-10 |
| Last Update Date | 2012-10-15 |