| NPI | 1255389409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: KY 30879) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: OH 35070669) |
| 207KA0200X Allergy & Immunology, Allergy (Licence: KY 30879) | |
| 207RA0201X Internal Medicine, Allergy & Immunology (Licence: OH 35070669) | |
| 207RA0201X Internal Medicine, Allergy & Immunology (Licence: OH 35 070669) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: OH 35070669) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2018-04-30 |