| NPI | 1508247024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: TX S1399) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL37667) |
| 208000000X Pediatrics (Licence: SC LL37667) | |
| Enumeration Date | 2015-06-10 |
| Last Update Date | 2021-07-28 |