| NPI | 1982601084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: NH 12404) |
| Additional Taxonomies | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: NH 12404) |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2021-08-31 |