| NPI | 1972520658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: AL DO-887) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AL DO-887) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2024-02-08 |