| NPI | 1972669380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: WA MD00043439) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD00043439) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2012-09-26 |