| NPI | 1710943790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NC 9500975) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 9500975) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2021-09-17 |