| NPI | 1023694064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: NC 2025-01766) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: NC 2025-01766) |
| 208000000X Pediatrics (Licence: IL 036.170110) | |
| 208000000X Pediatrics (Licence: NC 2025-01766) | |
| 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: NC 2025-01766) | |
| 207K00000X Allergy & Immunology (Licence: NC 2025-01766) | |
| Enumeration Date | 2021-03-21 |
| Last Update Date | 2025-07-02 |