| NPI | 1568806214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TX R7556) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10047039) |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2021-10-06 |