| NPI | 1740444991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 260959) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 260959) |
| 207K00000X Allergy & Immunology (Licence: MA 260959) | |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2025-05-16 |