| NPI | 1588637102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MA 223052) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 223052) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2015-02-13 |