| NPI | 1699758813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: FL ME77345) |
| Additional Taxonomies | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: CT 035659) |
| 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: CT 35659) | |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2013-07-18 |