| NPI | 1154482339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 286005) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 286005) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: PA MD065615L) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2018-04-12 |