| NPI | 1720548209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CA A196218) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 317862) |
| 208000000X Pediatrics (Licence: CA A196218) | |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2024-06-17 |