| NPI | 1508853631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: AL 14289) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL MD.14289) |
| 208000000X Pediatrics (Licence: AL MD.14289) | |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2021-11-12 |