| NPI | 1700913290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: PA MD472873) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: TX M6018) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2022-05-11 |