| NPI | 1205869237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 154963) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: WI 84129) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2024-10-17 |