| NPI | 1639424948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NC 2022-00628) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2022-00628) |
| Enumeration Date | 2012-07-23 |
| Last Update Date | 2023-12-18 |