| NPI | 1396703450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: WI 22420) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2005026718) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2011-12-08 |