| NPI | 1700859907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: UT 7666176-1204) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: CO 46865) |
| 207R00000X Internal Medicine (Licence: CO 46865) | |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2024-05-29 |