| NPI | 1629167549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MI 4301082935) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: MA 241209) |
| 207R00000X Internal Medicine (Licence: MA 241209) | |
| 207R00000X Internal Medicine (Licence: MI 4301082935) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2017-02-16 |