| NPI | 1487948121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology Allergy (Licence: TX P3497) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX BP10031044) |
| Enumeration Date | 2011-05-28 |
| Last Update Date | 2013-10-16 |