| NPI | 1477677979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP0905X Clinic/Center, Public Health, State or Local (Licence: NY 199508-1) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2022-07-21 |