| NPI | 1265420749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NY 114186) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 114186) |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2013-01-17 |