| NPI | 1205854015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: OK 25321) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: MO 109720) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2022-09-26 |