| NPI | 1093713638 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: OH 35 053762)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35 053762)  | 
| Enumeration Date | 2005-07-08 | 
| Last Update Date | 2022-07-14 |