| NPI | 1558320119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: GA 068372) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: PA MD-050257-L) |
| 208000000X Pediatrics (Licence: PA MD-050257-L) | |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2012-10-11 |