| NPI | 1225252125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TN 44699) |
| Additional Taxonomies | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: GA 000510) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2020-04-23 |