| NPI | 1225262074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 264661) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 264661) |
| Enumeration Date | 2009-05-07 |
| Last Update Date | 2023-07-06 |