| NPI | 1932161916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN MD0000039136) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: TN 39136) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2012-03-23 |