| NPI | 1932345618 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MD D0019078) | 
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: MD D0019078) | 
| Enumeration Date | 2008-12-30 | 
| Last Update Date | 2008-12-30 |