| NPI | 1861404220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: CO 22742) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO 22742) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2019-11-01 |