| NPI | 1518125988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: MA 239932) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 229171) |
| 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: MA 239932) | |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2018-06-04 |