| NPI | 1558397265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: WA MD60282454) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: TX L0055) |
| 207R00000X Internal Medicine (Licence: TX L0055) | |
| 208000000X Pediatrics (Licence: TX L0055) | |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2023-04-05 |