| NPI | 1457480055 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: TX L4312) | 
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: FL OS 9346) | 
| 207RA0201X Internal Medicine, Allergy & Immunology (Licence: TX L4312) | |
| Enumeration Date | 2007-03-02 | 
| Last Update Date | 2023-06-07 |