| NPI | 1013900638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: RI MD05146) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: RI MD05146) |
| 208000000X Pediatrics (Licence: RI MD05146) | |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2021-04-29 |