| NPI | 1902168107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MA 1013195) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 1013195) |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2024-10-02 |