| NPI | 1124168679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 240121) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 240121) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2015-01-06 |