| NPI | 1386648830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: LA 015657) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: LA 015657) |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2016-10-21 |