| NPI | 1730182858 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: PA MD024143E) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: PA MD024143E) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2018-06-10 |