| NPI | 1922068634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OS0020260L) |
| Additional Taxonomies | 207KI0005X Allergy & Immunology Clinical & Laboratory Immunology (Licence: PA OS002026L) |
| 207RH0000X Internal Medicine Hematology (Licence: PA OS002026L) | |
| Enumeration Date | 2006-03-25 |
| Last Update Date | 2011-03-08 |