| NPI | 1578583837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 156826-1) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: MI 156826-1) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2017-11-13 |