| NPI | 1003171299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NJ 61886) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: PA 030090E) |
| Enumeration Date | 2012-07-12 |
| Last Update Date | 2012-07-12 |