| NPI | 1710025556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: TX N2144) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036-113227) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2013-09-17 |