| NPI | 1215901426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: PR 15888) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME93943) |
| 207R00000X Internal Medicine (Licence: PR 15888) | |
| 208000000X Pediatrics (Licence: FL ME93943) | |
| 208000000X Pediatrics (Licence: PR 15888) | |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2016-06-10 |