| NPI | 1972582450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MN 26863) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: MN 26863) |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2022-01-05 |