| NPI | 1922230101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MN 56208) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: TN MD53016) |
| 207R00000X Internal Medicine (Licence: IL 125055926) | |
| 207R00000X Internal Medicine (Licence: TN MD53016) | |
| 208000000X Pediatrics (Licence: IL 125055926) | |
| 208000000X Pediatrics (Licence: MN 56208) | |
| 208000000X Pediatrics (Licence: TN 53016) | |
| 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: TN 53016) | |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2022-07-21 |