| NPI | 1568671584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: AL DO.1138) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: MS 2170) |
| 207R00000X Internal Medicine (Licence: MS 20170) | |
| 207R00000X Internal Medicine (Licence: AL DO.1138) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2022-04-29 |