| NPI | 1295231868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CO TL0009292) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 63026) |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2023-05-16 |