NPI | 1346495397 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 13192) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 39647-020) |
207K00000X Allergy & Immunology (Licence: MN 13192) | |
207K00000X Allergy & Immunology (Licence: WI 39647-020) | |
Enumeration Date | 2008-11-18 |
Last Update Date | 2008-11-25 |