| NPI | 1659458743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G38287) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: CA G38287) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2015-02-26 |