| NPI | 1750362034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MI 4301071851) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301071851) |
| 208000000X Pediatrics (Licence: MI 4301071851) | |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2018-06-12 |