| NPI | 1619014263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: MD D66119) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: MD 5458) |
| 207R00000X Internal Medicine (Licence: CT 042352) | |
| 207R00000X Internal Medicine (Licence: HI MD-13065) | |
| 207RA0201X Internal Medicine, Allergy & Immunology (Licence: NY 250668) | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2023-03-07 |