| NPI | 1073505723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 175782) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 175782) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 175782-1) | |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2021-12-20 |