| NPI | 1639764186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CO DR.0069602) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO DR.0069602) |
| Enumeration Date | 2021-03-06 |
| Last Update Date | 2026-06-02 |