| NPI | 1487603247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: WI 50185) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: AR E-6404) |
| 208000000X Pediatrics (Licence: WI 50185) | |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2013-06-12 |