| NPI | 1518073543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: OR MD14376) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: WA MD00027036) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OR MD14376) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WA MD00027036) | |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2007-07-10 |