| NPI | 1538401203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RA0201X Internal Medicine Allergy & Immunology (Licence: NV 17710) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology Allergy (Licence: NV 17710) |
| 207R00000X Internal Medicine (Licence: NV 17710) | |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2023-05-22 |