| NPI | 1710972872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TN 023784) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: TN 23784) |
| 207RA0201X Internal Medicine, Allergy & Immunology (Licence: TN 23784) | |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2023-05-17 |