| NPI | 1336361948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: KS 0432407) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-32407) |
| 207K00000X Allergy & Immunology (Licence: MO 2013045136) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2014-02-19 |