| NPI | 1699114017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: VA 0102204192) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0102204192) |
| 207K00000X Allergy & Immunology (Licence: WA DO.OP.70058826) | |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2026-05-28 |