NPI | 1770111858 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MN 69753) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 69753) |
207R00000X Internal Medicine (Licence: MN 30740) | |
Enumeration Date | 2020-04-01 |
Last Update Date | 2023-06-30 |