| NPI | 1801013016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: AZ 43063) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35089009) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2015-10-01 |