| NPI | 1760571954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207KI0005X Allergy & Immunology, Clinical & Laboratory Immunology (Licence: NJ 25MA11967400) |
| Additional Taxonomies | 2080I0007X Pediatrics, Clinical & Laboratory Immunology (Licence: NJ 25MA11967400) |
| 208000000X Pediatrics (Licence: CA G67169) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2026-08-05 |