| NPI | 1043449788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CA A108449) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: CO 54201) |
| 208000000X Pediatrics (Licence: CA A108449) | |
| 208000000X Pediatrics (Licence: CO 54201) | |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2021-05-17 |