| NPI | 1760836589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine Allergy & Immunology (Licence: MD D0102382) |
| Additional Taxonomies | 207RA0201X Internal Medicine Allergy & Immunology (Licence: VA 0101284815) |
| 207RA0201X Internal Medicine Allergy & Immunology (Licence: DC MD600003729) | |
| Enumeration Date | 2016-04-18 |
| Last Update Date | 2025-05-01 |