| NPI | 1912081746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: FL ME147005) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: WA MD00036784) |
| 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: WA MD00036784) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2023-03-06 |