| NPI | 1700346764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: VA 0101274577) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101274577) |
| Enumeration Date | 2019-03-24 |
| Last Update Date | 2024-07-18 |