| NPI | 1043439730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: WA MD60221603) |
| Additional Taxonomies | 2080P0201X Pediatrics Pediatric Allergy/Immunology (Licence: WA MD60221603) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2011-12-13 |