| NPI | 1215038088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: ME 017151) |
| Additional Taxonomies | 174400000X Specialist (Licence: ME 017151) |
| 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: ME 017151) | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2015-01-13 |