| NPI | 1972772176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 240664) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 240664) |
| Enumeration Date | 2008-02-21 |
| Last Update Date | 2022-03-04 |