| NPI | 1700945342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: TX E1324) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: CO 49177) |
| 207KI0005X Allergy & Immunology, Clinical & Laboratory Immunology (Licence: TX E1324) | |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2014-01-09 |