| NPI | 1134407430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MN 108882) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 108882) |
| Enumeration Date | 2011-08-03 |
| Last Update Date | 2022-09-01 |