| NPI | 1326333220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NE 30250) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: IA 215775743) |
| 207R00000X Internal Medicine (Licence: NE 6567) | |
| 208000000X Pediatrics (Licence: NE 6567) | |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2017-11-01 |