| NPI | 1487116638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CA A178465) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: CA A178465) |
| 207R00000X Internal Medicine (Licence: CA A178465) | |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2024-12-16 |