| NPI | 1073908091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MI 4301502619) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301502619) |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2021-06-28 |