| NPI | 1073044574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NE 35674) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 64170) |
| 207R00000X Internal Medicine (Licence: NE 35674) | |
| Enumeration Date | 2017-03-26 |
| Last Update Date | 2024-03-28 |