| NPI | 1235131467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 193200000X Multi-Specialty (Licence: NY 134718) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 134718) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2017-07-20 |