| NPI | 1053541581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: WI 67006-20) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: FL ME122884) |
| 207R00000X Internal Medicine (Licence: FL ME122884) | |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2023-02-27 |