| NPI | 1659362820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MA 53165) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 53165) |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2007-07-08 |