| NPI | 1386615409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 9230) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NH 9230) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2013-05-13 |