| NPI | 1255719597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: MA 290327) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: CA A143768) |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2022-07-21 |