| NPI | 1831186071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 49534) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: MA 49534) |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2014-10-08 |