| NPI | 1942268156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: NM 94250) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NM 94250) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2019-03-27 |