| NPI | 1326153917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: WI 57688-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VT 042-0011390) |
| 207R00000X Internal Medicine (Licence: NH RT1356) | |
| 207R00000X Internal Medicine (Licence: PA MD432543) | |
| 207K00000X Allergy & Immunology (Licence: PA MD432543) | |
| 207K00000X Allergy & Immunology (Licence: PA MT193706) | |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2024-03-13 |