| NPI | 1760794093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TN 2640) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MS T-2304) |
| 207R00000X Internal Medicine (Licence: TN 2640) | |
| 208000000X Pediatrics (Licence: TN 2640) | |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2016-06-27 |