| NPI | 1083615033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: MD D0032003) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: DC MD16084) |
| 208000000X Pediatrics (Licence: MD D0032003) | |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2020-03-04 |