| NPI | 1538167259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine Allergy & Immunology (Licence: VA 0101254740) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology Allergy (Licence: CO 20763) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2014-05-21 |