| NPI | 1831285618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: WI 43561) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 43561) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2022-07-21 |