| NPI | 1174630321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV 17024) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: WV 17024) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2008-05-13 |