| NPI | 1306378112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: NY 331132) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD049222) |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2024-07-24 |