| NPI | 1669459665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MN 30985) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MN 30985) |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2020-08-19 |