| NPI | 1306956586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TN MD46000) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 053320) |
| 174400000X Specialist (Licence: TN 46000) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2012-02-24 |