| NPI | 1073956983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 290601) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 290601) |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2018-06-01 |