| NPI | 1376707307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: WI 54168) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 54168) |
| 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: WI 54168) | |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2021-01-14 |