| NPI | 1679596696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 162134) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: ID M-17631) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2024-01-16 |