| NPI | 1285079426 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CA A137196) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A137196) | 
| 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: CA A137196) | |
| Enumeration Date | 2013-05-01 | 
| Last Update Date | 2023-07-03 |