| NPI | 1679584486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CA C50307) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA C50307) |
| 207RR0500X Internal Medicine, Rheumatology (Licence: CA C50307) | |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2007-07-08 |