| NPI | 1922217124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM 98-233) |
| Additional Taxonomies | 207KI0005X Allergy & Immunology Clinical & Laboratory Immunology (Licence: NM 98-233) |
| 207ZI0100X Pathology Immunopathology (Licence: NM 98-233) | |
| 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: NM 98-233) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2016-01-19 |