| NPI | 1972829125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: OH 35.098500) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.098500) |
| Enumeration Date | 2010-04-13 |
| Last Update Date | 2023-11-09 |