| NPI | 1457588642 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: OH 35099929) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35099929) | 
| Enumeration Date | 2009-06-16 | 
| Last Update Date | 2023-07-19 |