| NPI | 1316935943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine Allergy & Immunology (Licence: IA 22111) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 22111) |
| 207RI0001X Internal Medicine Clinical & Laboratory Immunology (Licence: IA 22111) | |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2007-11-28 |