| NPI | 1760003529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 322282) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 322282) |
| Enumeration Date | 2020-05-04 |
| Last Update Date | 2025-06-09 |