| NPI | 1003435058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: WI 81929-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 81929-20) |
| Enumeration Date | 2020-04-10 |
| Last Update Date | 2025-11-11 |