| NPI | 1134103179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY NYS116727) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 116727) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2021-06-10 |