| NPI | 1396924734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME107904) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 246256) |
| Enumeration Date | 2007-11-02 |
| Last Update Date | 2010-08-19 |