| NPI | 1205827490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: PA MD432067) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: MO R8310) |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2013-04-12 |