| NPI | 1649495003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: OH 35.093366) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57012266) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2012-10-05 |