| NPI | 1912137951 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: CA c130942) | 
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 254181) | 
| Enumeration Date | 2009-07-24 | 
| Last Update Date | 2018-07-17 |