| NPI | 1811962079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MA 33199) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 33199) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2010-09-07 |