| NPI | 1700812708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: VA 0101237123) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101237123) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2024-02-02 |