| NPI | 1467576322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology Allergy (Licence: UT 9291183-1204) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 02003323A) |
| 208000000X Pediatrics (Licence: OH 58.002130) | |
| Enumeration Date | 2007-03-18 |
| Last Update Date | 2021-09-08 |