| NPI | 1497751036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: AL 00007246) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: AL 00007246) |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: AL 00007246) | |
| 207Y00000X Otolaryngology (Licence: AL 00007246) | |
| 208600000X Surgery (Licence: AL 00007246) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: AL 00007246) | |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2008-04-04 |