| NPI | 1376593673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: SC MMD 38111 MD) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 232915) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2020-12-09 |