| NPI | 1083655781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: CT 013185) |
| Additional Taxonomies | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: CT 013185) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2011-09-29 |