| NPI | 1548441702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NC 2009-01500) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: NC 2009-01500) |
| 208000000X Pediatrics (Licence: FL OS9850) | |
| Enumeration Date | 2007-11-16 |
| Last Update Date | 2018-06-25 |