| NPI | 1871506808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G34195) |
| Additional Taxonomies | 174400000X Specialist |
| 207K00000X Allergy & Immunology (Licence: CA G34195) | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2014-05-01 |