| NPI | 1033523253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: OH 35.132363) |
| Additional Taxonomies | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: OH 35.132363) |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2019-08-26 |