| NPI | 1831171891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: WY 4234A) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: NE 19482) |
| 207RA0201X Internal Medicine, Allergy & Immunology (Licence: CO 37760) | |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2014-02-20 |