| NPI | 1134499593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: IL 036.064589) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: CA G54695) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: NJ 25MA05274300) | |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2012-01-03 |