| NPI | 1558347047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: IA 52071) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: MA 219164) |
| 207KI0005X Allergy & Immunology Clinical & Laboratory Immunology (Licence: MA 219164) | |
| 207R00000X Internal Medicine (Licence: MA 219164) | |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2023-10-23 |