| NPI | 1174873277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE c1-0000685) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: DE C1-0000685) |
| Enumeration Date | 2012-09-16 |
| Last Update Date | 2012-09-16 |