| NPI | 1164835724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: DC MD045081) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD045081) |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2023-03-16 |