| NPI | 1316381650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CA A169117) |
| Additional Taxonomies | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: IL 036146945) |
| 207K00000X Allergy & Immunology (Licence: IL 036.146945) | |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2020-08-28 |