| NPI | 1780754408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CO 25964) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO 25964) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2013-06-06 |