| NPI | 1659421642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TX E0423) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX E0423) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2007-07-08 |