| NPI | 1487601316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 48180) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: MN 48180) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2024-12-11 |