| NPI | 1609865880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology Allergy (Licence: ID M-7118) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: ID M-7118) |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2016-05-18 |