| NPI | 1447236393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MI 4301043746) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: MI 4301043746) |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2021-10-21 |