| NPI | 1275828717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics Pediatric Allergy/Immunology (Licence: TN MD65969) |
| Additional Taxonomies | 2080P0201X Pediatrics Pediatric Allergy/Immunology (Licence: KS 04-40205) |
| 2080P0201X Pediatrics Pediatric Allergy/Immunology (Licence: MO 2017023519) | |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2022-07-25 |