| NPI | 1750362505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 153515) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: MA MA153515) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2022-07-21 |