| NPI | 1659354082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: CT 021424) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: CT 021424) |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2015-10-06 |