| NPI | 1255541231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 296437) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: PA MT181140) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2019-01-29 |