| NPI | 1821046095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 268115) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: MA 82080) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2014-07-22 |