NPI | 1104875814 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NJ MA060236) |
Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: NJ MA06023600) |
Enumeration Date | 2006-05-09 |
Last Update Date | 2022-01-28 |