| NPI | 1205825288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: WA MD 60194720) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD070164L) |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2021-04-26 |