| NPI | 1457419616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: ND PT11501) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: TX M4963) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2022-09-20 |