| NPI | 1053353755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: MT MED-PHYS-LIC-62538) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: ID M-12751) |
| 207R00000X Internal Medicine (Licence: CA A85686) | |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2019-04-22 |