| NPI | 1780779595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 109147) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: GA 037014) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: CT 015153) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2008-12-10 |