| NPI | 1164798146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: PA MD461509) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD461509) |
| Enumeration Date | 2012-03-23 |
| Last Update Date | 2019-10-14 |