| NPI | 1811456759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: ME MD29321) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ME MD29321) |
| 207K00000X Allergy & Immunology (Licence: WI 81788-20) | |
| 208000000X Pediatrics (Licence: ME MD29321) | |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2025-11-21 |