| NPI | 1124523048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: MA 288038) |
| Additional Taxonomies | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: MA 288038) |
| Enumeration Date | 2018-03-25 |
| Last Update Date | 2021-09-03 |