| NPI | 1780668392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 140998) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NY 233206) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2019-02-25 |