| NPI | 1649260415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: GA 72334) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 59359) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: MA 59359) | |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2014-10-06 |