| NPI | 1679751952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MN 56840) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 18662) |
| 207R00000X Internal Medicine (Licence: WI 55454) | |
| Enumeration Date | 2008-02-08 |
| Last Update Date | 2017-04-04 |