| NPI | 1639125651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 122394) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: NY 122394) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 122394) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2007-07-08 |