| NPI | 1588710644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: VA 0101241418) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101241418) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2024-03-05 |