| NPI | 1003998816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: OK 14591) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OK 14591) |
| 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: OK 14591) | |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2012-09-05 |