| NPI | 1922068634 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| 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 |