| NPI | 1669476495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: MO R1F19) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO R1F19) |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2018-01-24 |