| NPI | 1417943747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: IA 23376) |
| Additional Taxonomies | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: IA 23376) |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2007-12-13 |