| NPI | 1013113513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: OH 35.139794) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: MA 249754) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 251269) | |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2022-02-02 |