| NPI | 1619939055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: IN 01063093A) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: TX L8034) |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2012-04-05 |