| NPI | 1962592147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 192354) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NY 192354) |
| 207KA0200X Allergy & Immunology, Allergy (Licence: NY 192354) | |
| 207RA0201X Internal Medicine, Allergy & Immunology (Licence: NY 192354) | |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2013-03-14 |