| NPI | 1831650514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TX V2424) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX V2424) |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2026-05-07 |