| NPI | 1649274630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: GA 036137) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: GA 036137) |
| Enumeration Date | 2005-06-08 |
| Last Update Date | 2017-01-18 |