| NPI | 1336120203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MI 4301035980) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: MI 4301035980) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2017-04-10 |