| NPI | 1063487700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KI0005X Allergy & Immunology, Clinical & Laboratory Immunology (Licence: MA 46921) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: MA 46921) |
| 207R00000X Internal Medicine (Licence: MA 46921) | |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2025-09-11 |