| NPI | 1245525823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: VT 042.0013754) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 287981) |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2022-07-21 |