| NPI | 1710083555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: FL ME132466) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: MA 151493) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2022-08-18 |