| NPI | 1669766325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MI 4301108955) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: MO 2014010402) |
| 207R00000X Internal Medicine (Licence: IA R-9168) | |
| Enumeration Date | 2011-05-30 |
| Last Update Date | 2021-03-17 |