| NPI | 1275522583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: FL ME0042119) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME0042119) |
| 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: FL ME0042119) | |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2007-07-08 |