| NPI | 1205996402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: FL ME120908) |
| Additional Taxonomies | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: WI 56579) |
| 207K00000X Allergy & Immunology (Licence: WI 56579) | |
| 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: DE C10006135) | |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2015-05-06 |