| NPI | 1104389626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: CO 0064971) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO 0064971) |
| Enumeration Date | 2019-04-11 |
| Last Update Date | 2024-08-12 |