| NPI | 1659577070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NC 2008-00846) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2008-00846) |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2021-08-16 |