| NPI | 1255020004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: WI 87073-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.081244) |
| Enumeration Date | 2023-05-05 |
| Last Update Date | 2026-06-20 |