| NPI | 1124255328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MO 2016017550) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: KS 0439073) |
| 207R00000X Internal Medicine (Licence: KS 0439073) | |
| 207R00000X Internal Medicine (Licence: MO 2016017550) | |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2016-08-03 |