| NPI | 1376785691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: WI 55777) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 55777) |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2024-03-13 |