| NPI | 1700058310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: LA MD.200766) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA MD.200766) |
| Enumeration Date | 2008-03-24 |
| Last Update Date | 2018-03-08 |