| NPI | 1619065760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 34002468B) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: OH 34002468B) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2007-07-08 |