| NPI | 1770659096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: VA 0101047053) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D42566) |
| 207R00000X Internal Medicine (Licence: DC MD19273) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2011-12-15 |