| NPI | 1558407981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: PA MD432871) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD432871) |
| 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: DE C10010517) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2013-11-21 |