| NPI | 1548288277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 237162) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: NY 61-18162) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2025-07-31 |