| NPI | 1891718250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MA 213978) |
| Additional Taxonomies | 207KI0005X Allergy & Immunology Clinical & Laboratory Immunology (Licence: MA 213978) |
| 207R00000X Internal Medicine (Licence: MA 213978) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2016-05-03 |