| NPI | 1003263955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NC 2019-00392) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 268165) |
| 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: NC 2019-00392) | |
| Enumeration Date | 2016-05-20 |
| Last Update Date | 2023-10-03 |