| NPI | 1225007644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: ID M-15682) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NV 21289) |
| 207K00000X Allergy & Immunology (Licence: VA 0101234499) | |
| 208000000X Pediatrics (Licence: VA 0101234499) | |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2022-04-18 |