| NPI | 1285608919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MA 60196) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 60196) |
| 2080P0214X Pediatrics Pediatric Pulmonology (Licence: MA 60196) | |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2012-08-06 |