| NPI | 1205844511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: KY 27214) |
| Additional Taxonomies | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: KY 27214) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2008-05-22 |