| NPI | 1730153750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: PR 4192) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 4192) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2013-06-11 |