| NPI | 1780682351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 191818) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 191818) |
| 363A00000X Physician Assistant (Licence: NY 191818) | |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2023-07-07 |