| NPI | 1568484293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CA A41221) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A41221) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2022-01-20 |