| NPI | 1194882902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: WA MD00026838) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD00026838) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2009-10-07 |