| NPI | 1790730273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TX K2579) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX K2579) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2024-01-09 |