| NPI | 1366694424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CO DR.0052252) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: CO DR.0052252) |
| 207RA0201X Internal Medicine, Allergy & Immunology (Licence: PA MD443963) | |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2021-05-04 |