| NPI | 1043310261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: IL 036-125826) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 248493) |
| 208000000X Pediatrics (Licence: OH 35089736) | |
| 208000000X Pediatrics (Licence: NJ 25MA08039700) | |
| 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: MI 4301107932) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2023-08-10 |