| NPI | 1881806875 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: LA MD.203247)  | 
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: LA MD.203247)  | 
| 207R00000X Internal Medicine (Licence: LA MD.203247)  | |
| Enumeration Date | 2007-05-04 | 
| Last Update Date | 2019-09-13 |