| NPI | 1922129485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA L-217503) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: MA L-217503) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2008-02-11 |