| NPI | 1215915707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A87397) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: CA A87397) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2016-03-24 |