| NPI | 1659320505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0046412) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: MD D0046412) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2010-02-02 |