| NPI | 1326364811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: FL ME128352) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: GA 6618) |
| Enumeration Date | 2010-04-09 |
| Last Update Date | 2018-10-17 |