| NPI | 1912155524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: WA MD60323861) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301092002) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: WA 60323861) | |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2017-04-03 |