| NPI | 1811095854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MN 47758) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 47758) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2010-08-17 |