| NPI | 1831416197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: VA 0102203064) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: TX R8534) |
| Enumeration Date | 2010-04-27 |
| Last Update Date | 2021-11-05 |