| NPI | 1851452213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CA G37345) |
| Additional Taxonomies | 207RR0500X Internal Medicine Rheumatology (Licence: CA G37345) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2020-03-13 |