| NPI | 1073659546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 14664) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: WI 14664) |
| 207Q00000X Family Medicine (Licence: WI 14664) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2012-12-05 |