| NPI | 1124082821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: OH 35079988) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: OH 35-079988) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35079988A) | |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2022-03-29 |