| NPI | 1396972535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TX Q6720) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R71544) |
| 208000000X Pediatrics (Licence: AZ R71544) | |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2017-04-14 |