| NPI | 1861997090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: FL ME169595) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: FL ME169595) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2026-06-30 |