| NPI | 1255642294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NE 2447) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 9407508) |
| 207KA0200X Allergy & Immunology, Allergy (Licence: MN 58998) | |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2021-10-05 |