| NPI | 1982681136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MN 24660) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: MN 24660) |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2020-08-12 |