| NPI | 1629400635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: NY 314664) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 055048) |
| 207R00000X Internal Medicine (Licence: PA OT015311) | |
| 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: DC DO034862) | |
| 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: MD H0088174) | |
| Enumeration Date | 2013-07-31 |
| Last Update Date | 2022-06-09 |