| NPI | 1689630345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: OH 35-082777) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35082777) |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2021-01-08 |