| NPI | 1952347916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: WA MD00027574) |
| Additional Taxonomies | 207KI0005X Allergy & Immunology Clinical & Laboratory Immunology (Licence: WA MD00027574) |
| 2080P0201X Pediatrics Pediatric Allergy/Immunology (Licence: WA MD00027574) | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2021-12-28 |