| NPI | 1780811653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: FL ME110214) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A102234) |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2013-02-26 |