| NPI | 1801208590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NY 303459) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 303459) |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2022-08-22 |