| NPI | 1922363001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine Allergy & Immunology (Licence: UT 10764222-1204) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036-137661) |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2023-11-27 |