| NPI | 1497818264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2003-00568) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NC 2003-00568) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2018-03-29 |