| NPI | 1386713329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TX N5346) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 201076) |
| 207R00000X Internal Medicine (Licence: TX N5346) | |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2025-08-13 |