| NPI | 1043248719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G85954) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: CA G85954) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2025-04-09 |