| NPI | 1316334253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: WI 3768-320) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: ND PT18107) |
| 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: MI 4301501309) | |
| 207K00000X Allergy & Immunology (Licence: ND PT18107) | |
| 207RA0201X Internal Medicine, Allergy & Immunology (Licence: OH 35.143726) | |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2024-02-16 |