| NPI | 1881638625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: MI KB050601) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MI KB050601) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2012-03-13 |