| NPI | 1710077409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 188575) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 188575) |
| 174400000X Specialist (Licence: NY 188575) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2024-01-17 |