| NPI | 1952540148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: VA 010148364) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: PA MD042001L) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: DE C1-0004605) | |
| Enumeration Date | 2009-02-11 |
| Last Update Date | 2009-02-11 |