| NPI | 1902996549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: VA 0101056147) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101056147) |
| 208000000X Pediatrics (Licence: VA 0101056147) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2012-07-11 |