| NPI | 1710015425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CA G61950) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G61950) |
| 208000000X Pediatrics (Licence: CA G61950) | |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2025-12-08 |