| NPI | 1760592349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NE 10) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NE 10) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2017-03-24 |