| NPI | 1770690141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MA 39891) |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine (Licence: MA 39891) |
| 208000000X Pediatrics (Licence: MA 39891) | |
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: MA 39891) | |
| 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: MA 39891) | |
| 2080P0008X Pediatrics, Neurodevelopmental Disabilities (Licence: MA 39891) | |
| 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: MA 39891) | |
| 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: MA 39891) | |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MA 39891) | |
| 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: MA 39891) | |
| 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: MA 39891) | |
| 2080T0002X Pediatrics, Medical Toxicology (Licence: MA 39891) | |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: MA 39891) | |
| 2083T0002X Preventive Medicine, Medical Toxicology (Licence: MA 39891) | |
| 208D00000X General Practice (Licence: MA 39891) | |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2007-07-09 |