| NPI | 1669587929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101230499) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: VA 0101230499) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2008-11-24 |