| NPI | 1356892293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: MA 292418) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: MA 278481) |
| 208000000X Pediatrics (Licence: MA 278481) | |
| Enumeration Date | 2016-10-15 |
| Last Update Date | 2022-07-27 |