| NPI | 1023065760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207KA0200X Allergy & Immunology Allergy (Licence: CA C33136) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA C331360) |
| 208000000X Pediatrics (Licence: CA C331360) | |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2023-06-12 |