NPI | 1700878691 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: UT 12974480-1205) |
Additional Taxonomies | 208000000X Pediatrics (Licence: UT 12974480-1205) |
Enumeration Date | 2005-08-17 |
Last Update Date | 2023-03-01 |