| NPI | 1487910766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: OR MD187596) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD187596) |
| 208000000X Pediatrics (Licence: OR MD187596) | |
| 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: OR MD187596) | |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2018-06-15 |