| NPI | 1891782777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 157414) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME0076743) |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2009-12-23 |