| NPI | 1144688854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MI 4301056937) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301056937) |
| Enumeration Date | 2016-02-09 |
| Last Update Date | 2018-08-29 |