| NPI | 1942576947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CT 056435) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 056435) |
| Enumeration Date | 2012-03-24 |
| Last Update Date | 2022-04-14 |