| NPI | 1659440964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 9920) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: SC 9920) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2025-09-11 |