| NPI | 1811999485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: MO 102527) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 102527) |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2020-02-19 |