| NPI | 1417207812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: VA 0101264117) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT201908) |
| 207R00000X Internal Medicine (Licence: VA 0101264117) | |
| Enumeration Date | 2012-09-12 |
| Last Update Date | 2022-08-16 |