| NPI | 1073503843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: NH 24463) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: FL OS10177) |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2023-08-04 |