| NPI | 1750312856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 22445) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: MN 22445) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2014-03-18 |