| NPI | 1790947190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NY 259281) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 259281) |
| 207RR0500X Internal Medicine, Rheumatology (Licence: NY 259281) | |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2014-07-21 |