| NPI | 1477852689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: FL ME118840) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME118840) |
| Enumeration Date | 2011-03-28 |
| Last Update Date | 2021-02-16 |