| NPI | 1154322923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: LA 10447R) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA 10447R) |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2021-11-05 |