| NPI | 1174530414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: AZ 45678) |
| Additional Taxonomies | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: AZ 45678) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2024-11-26 |