| NPI | 1518916972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: FL OS5550) |
| Additional Taxonomies | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: FL OS5550) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2019-07-08 |