| NPI | 1760846455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 303385) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 303385) |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2023-07-22 |