| NPI | 1053006411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: VA 0102208931) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0102208931) |
| 208D00000X General Practice (Licence: VA 0102208931) | |
| Enumeration Date | 2023-04-10 |
| Last Update Date | 2026-06-11 |