| NPI | 1164468955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: UT 8771272-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35084855) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2022-07-21 |