| NPI | 1699114017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: VA 0102204192) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0102204192) |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2022-07-21 |