| NPI | 1265647945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MA 240557) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 240557) |
| 207R00000X Internal Medicine (Licence: MA 240557) | |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2026-01-25 |