| NPI | 1639143290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: OH 35046087) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: OH 35046087) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2016-09-07 |