| NPI | 1407940596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: NC 2009-01203) |
| Additional Taxonomies | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: GA 84016) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2022-11-29 |