| NPI | 1811946916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: PA MD072638L) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD072638L) |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2020-06-22 |