| NPI | 1760839211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: AZ 55863) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R75864) |
| Enumeration Date | 2016-05-14 |
| Last Update Date | 2026-07-24 |