| NPI | 1740234434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NC 2006-01731) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: LA 15602r) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: OH 35-84018) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2011-04-13 |