| NPI | 1750515268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: AZ 50429) |
| Additional Taxonomies | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: AZ 50429) |
| Enumeration Date | 2009-05-12 |
| Last Update Date | 2024-11-15 |