| NPI | 1619015088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: WI 57120-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 57120-20) |
| 208000000X Pediatrics (Licence: WI 57120-20) | |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2020-04-09 |