| NPI | 1639668429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: OH 35.147085) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.147085) |
| Enumeration Date | 2018-05-07 |
| Last Update Date | 2023-11-30 |