| NPI | 1811077969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CA A39046) |
| Additional Taxonomies | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: CA 000000A39046) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2025-03-26 |