| NPI | 1649348913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101037045) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: VA 0101037045) |
| Enumeration Date | 2006-12-02 |
| Last Update Date | 2009-10-02 |