| NPI | 1164716171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MA 268300) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125059588) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2017-05-08 |