NPI | 1245484351 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: FL ME125929) |
Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NJ 25MA06986500) |
208000000X Pediatrics (Licence: FL ME125929) | |
2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: FL ME125929) | |
Enumeration Date | 2008-11-17 |
Last Update Date | 2024-06-05 |