| NPI | 1609968015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN MD14143) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: TN 14143) |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2022-05-31 |