| NPI | 1720164403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: WA MD00040259) |
| Additional Taxonomies | 2080P0216X Pediatrics, Pediatric Rheumatology (Licence: WA MD00040259) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2009-03-03 |