| NPI | 1043439730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: OR MD206222) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OR MD206222) |
| 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: WA MD60221603) | |
| 207K00000X Allergy & Immunology (Licence: WA MD60221603) | |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2024-12-23 |