| NPI | 1255451886 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TX N9069) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX N9069) | 
| Enumeration Date | 2007-03-29 | 
| Last Update Date | 2023-11-28 |