| NPI | 1568444594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MA 70343) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 70343) |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2021-12-16 |