| NPI | 1972923860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NE 29432) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 29432) |
| Enumeration Date | 2014-04-18 |
| Last Update Date | 2026-06-18 |