| NPI | 1003859059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: HI MD12315) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: HI MD12315) |
| 207R00000X Internal Medicine (Licence: HI MD12315) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2007-12-07 |