| NPI | 1629185103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MO R7D62) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO R7D62) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2012-11-13 |