| NPI | 1720373343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KI0005X Allergy & Immunology, Clinical & Laboratory Immunology (Licence: OH 35.097227) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.097227) |
| Enumeration Date | 2011-06-10 |
| Last Update Date | 2014-09-05 |