| NPI | 1942495825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: PA OS015695) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 046528) |
| 208000000X Pediatrics (Licence: CT 046528) | |
| Enumeration Date | 2007-09-13 |
| Last Update Date | 2023-06-05 |