| NPI | 1962728642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TX Q0616) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX Q0616) |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2019-09-23 |