| NPI | 1619926193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: FL ME0062618) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: FL ME0062618) |
| 207RA0201X Internal Medicine, Allergy & Immunology (Licence: FL ME0062618) | |
| 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: FL ME0062618) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2020-12-22 |