| NPI | 1063496982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MA 74282) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 74282) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MA 74282) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MA 74282) | |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2019-04-05 |