| NPI | 1750590097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NC 2012-00072) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2012-00072) |
| 261QI0500X Clinic/Center, Infusion Therapy (Licence: NC 201200072) | |
| 207RR0500X Internal Medicine, Rheumatology (Licence: NC 2012-00072) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2026-06-10 |