| NPI | 1053385880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: MO 2010028283) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2010028283) |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2018-01-24 |