| NPI | 1245205517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD033909E) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: PA MD033909E) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2019-09-18 |