| NPI | 1871752600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: PA OS018745) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MB09104700) |
| 208000000X Pediatrics (Licence: NJ 25MB09104700) | |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2020-08-31 |