| NPI | 1386724615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics Pediatric Allergy/Immunology (Licence: CO DR.0043753) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: CO 43753) |
| 208000000X Pediatrics (Licence: CO 43753) | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2018-12-04 |