| NPI | 1639479736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NY 273534) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: NY 273534) |
| 207R00000X Internal Medicine (Licence: NY 273534) | |
| Enumeration Date | 2010-10-24 |
| Last Update Date | 2015-02-25 |