| NPI | 1548354475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TN 3958) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 31722) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2015-09-02 |