| NPI | 1568967024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CO DR.0070629) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO DR.0070629) |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2023-11-27 |