| NPI | 1093848988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CT 048479) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 048479) |
| 208000000X Pediatrics (Licence: NY 240687) | |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2022-04-14 |