| NPI | 1306875471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MI 4301113645) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301113645) |
| 207RA0201X Internal Medicine, Allergy & Immunology (Licence: MI 4301113645) | |
| 208000000X Pediatrics (Licence: MO 2005007047) | |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2023-03-13 |