| NPI | 1912165028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MD D0069497) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 236152 DUP) |
| Enumeration Date | 2008-05-26 |
| Last Update Date | 2021-02-23 |