NPI | 1376502096 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MI 4301084904) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301084904) |
Enumeration Date | 2006-03-21 |
Last Update Date | 2021-02-04 |