| NPI | 1962964551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: IA MD-51474) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD477917) |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2025-01-24 |