| NPI | 1043486863 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: CA A84001) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA a84001) | 
| Enumeration Date | 2008-05-01 | 
| Last Update Date | 2018-09-19 |