| NPI | 1083148167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: NJ 25MA11792000) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: MA 283077) |
| 208000000X Pediatrics (Licence: MA 283077) | |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2023-08-31 |