| NPI | 1891776563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: FL ME0076685) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: AL 20878) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2023-03-07 |