| NPI | 1649266966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VT 0420007795) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: VT 042.0007795) |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2014-12-04 |