| NPI | 1760429781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: OR MD170999) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: HI MD5594) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2026-08-25 |