| NPI | 1225340540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: GA 74970) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS T-2347) |
| Enumeration Date | 2010-07-02 |
| Last Update Date | 2023-02-28 |