| NPI | 1104828250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: GA 056116) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: SC 27796) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2016-04-05 |