| NPI | 1881770741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NY 258115) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 221951) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2019-04-04 |