| NPI | 1881607281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: OR MD12304) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: WA MD00034225) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2007-07-11 |