| NPI | 1407863533 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: TX S2033) | 
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: NJ 25MA08413900) | 
| 207R00000X Internal Medicine (Licence: TX S2033) | |
| 207R00000X Internal Medicine (Licence: NJ 25MA08413900) | |
| Enumeration Date | 2006-08-02 | 
| Last Update Date | 2023-08-10 |