| NPI | 1902838972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NV 14560) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 197655) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2020-09-17 |