| NPI | 1497778120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NH 5031) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: NH 5031) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2011-07-21 |