| NPI | 1922081702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MA 223612) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 223612) |
| Enumeration Date | 2005-11-25 |
| Last Update Date | 2021-12-20 |