| NPI | 1336300276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: WI 55834-020) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 55834) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2014-08-05 |