| NPI | 1316988850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: IL 036-109430) |
| Additional Taxonomies | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: WI 49223) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2022-01-05 |