| NPI | 1700888013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 169476) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 169476) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2013-03-22 |