| NPI | 1700864881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NM 2000-219) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NM 2000-219) |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2026-06-08 |