| NPI | 1710989249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NY 204070-1) |
| Additional Taxonomies | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: NY 204070-1) |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2013-01-25 |