| NPI | 1740577378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: FL ME119185) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301099351) |
| Enumeration Date | 2011-07-04 |
| Last Update Date | 2015-11-11 |