| NPI | 1255420188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TN 42638) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: MI 4301078042) |
| 208000000X Pediatrics (Licence: MI 4301078042) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2007-09-28 |