| NPI | 1083774327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: OH 35. 093231) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35 093231) |
| 207R00000X Internal Medicine (Licence: MD D62806) | |
| 207RA0201X Internal Medicine, Allergy & Immunology (Licence: MD D62806) | |
| Enumeration Date | 2006-12-09 |
| Last Update Date | 2021-05-06 |