| NPI | 1750369682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: OH 35-122767) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: MN 48074) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: NJ MA07803400) | |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2014-06-26 |