| NPI | 1558532275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: FL ME107408) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME107408) |
| Enumeration Date | 2008-03-20 |
| Last Update Date | 2019-09-23 |