| NPI | 1013012772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 149046) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: NY 149046) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2019-02-06 |