| NPI | 1639138449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 32675) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MA 32675) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: MA 32675) | |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2012-02-02 |