| NPI | 1659374411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics Pediatric Allergy/Immunology (Licence: WI 26831) |
| Additional Taxonomies | 2080P0201X Pediatrics Pediatric Allergy/Immunology (Licence: IA 29460) |
| 2080P0201X Pediatrics Pediatric Allergy/Immunology (Licence: MN 37440) | |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2013-10-08 |