| NPI | 1447663380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MA 609657) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 260538) |
| 207RA0201X Internal Medicine, Allergy & Immunology (Licence: MA 260538) | |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2021-03-30 |