| NPI | 1700053592 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NJ 25MA08420800) | 
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 240501) | 
| 207RI0200X Internal Medicine, Infectious Disease (Licence: PA MD433997) | |
| Enumeration Date | 2008-05-12 | 
| Last Update Date | 2011-05-19 |