| NPI | 1619188737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MI 4301093149) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301093149) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: OH 35084079) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2017-07-05 |