| NPI | 1003071713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: FL ME133105) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: MA 247405) |
| 207R00000X Internal Medicine (Licence: PR 12022R) | |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2021-03-30 |