| NPI | 1912904038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: CA C10005662) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: CA C10005662) |
| 207KA0200X Allergy & Immunology, Allergy (Licence: CA C10005662) | |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2025-09-11 |