| NPI | 1407877004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TN 48645) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2006015608) |
| 207KA0200X Allergy & Immunology Allergy (Licence: TN 48645) | |
| 207K00000X Allergy & Immunology (Licence: NY 254120-1) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2023-11-21 |