| NPI | 1720005267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: OH 35128597) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: OH 35128597) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2022-02-15 |