| NPI | 1922368539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: MO 2015021548) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 290070) |
| 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: KS 04-42465) | |
| Enumeration Date | 2012-05-17 |
| Last Update Date | 2021-03-15 |