| NPI | 1205491842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: VA 0101270342) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101270342) |
| Enumeration Date | 2019-05-09 |
| Last Update Date | 2023-08-21 |