| NPI | 1124022058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL me73282) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: FL ME0073282) |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2017-02-24 |