| NPI | 1538666839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MN 65821) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 65821) |
| 207R00000X Internal Medicine (Licence: MN 29130) | |
| Enumeration Date | 2018-04-12 |
| Last Update Date | 2024-01-22 |