| NPI | 1891010682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TN 51471) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: TN 51471) |
| 207R00000X Internal Medicine (Licence: TN 51471) | |
| 207RA0201X Internal Medicine, Allergy & Immunology (Licence: TN 51471) | |
| 208000000X Pediatrics (Licence: TN 51471) | |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2024-08-08 |