| NPI | 1407016348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: AZ 46987) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125054682) |
| Enumeration Date | 2008-06-13 |
| Last Update Date | 2019-07-02 |