| NPI | 1033569439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: PA 12495) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 4273) |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2025-02-24 |