| NPI | 1235190380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00012638) |
| Additional Taxonomies | 207KI0005X Allergy & Immunology, Clinical & Laboratory Immunology (Licence: WA MD00012638) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2008-03-04 |