| NPI | 1912152687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ R70452) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: AZ R70452) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: CA 126802) | |
| Enumeration Date | 2008-11-22 |
| Last Update Date | 2016-06-11 |