| NPI | 1669032355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: PA MD478681) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD478681) |
| Enumeration Date | 2019-06-16 |
| Last Update Date | 2024-08-22 |