| NPI | 1144512096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MT MED-PHYS-LIC-50737) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 62412) |
| 207K00000X Allergy & Immunology (Licence: WI 62412) | |
| 207KA0200X Allergy & Immunology, Allergy (Licence: WI 62412) | |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2016-09-01 |