| NPI | 1972861896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: CT 045599) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 182901) |
| Enumeration Date | 2012-04-28 |
| Last Update Date | 2012-04-28 |