| NPI | 1215991575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 17295) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: CT 017295) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2022-02-03 |