| NPI | 1275064388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CA A169574) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: CA A169574) |
| 208000000X Pediatrics (Licence: CA A169574) | |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2024-04-16 |