| NPI | 1164529889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: VA 0101050993) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: WV 17847) |
| 207R00000X Internal Medicine (Licence: VA 0101050993) | |
| 207R00000X Internal Medicine (Licence: WV 17847) | |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2012-12-07 |