| NPI | 1780770362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TX N3241) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 19074) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2023-02-23 |