| NPI | 1619940483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MN 42713) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: MN 42713) |
| 207K00000X Allergy & Immunology (Licence: AZ 67114) | |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2023-04-03 |