| NPI | 1013229814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: OH 35.121150) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2010017220) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2023-10-11 |