| NPI | 1245686641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NJ 25MB11105300) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10056889) |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2021-06-07 |