| NPI | 1366568420 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 243772)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.083517)  | 
| 207RI0200X Internal Medicine, Infectious Disease (Licence: OH 35.083517)  | |
| 207R00000X Internal Medicine (Licence: NY 243772)  | |
| Enumeration Date | 2007-03-21 | 
| Last Update Date | 2011-02-25 |