| NPI | 1053739714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: WI 65024-20) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: WI 65024-20) |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2021-02-23 |