| NPI | 1851343602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: OH 35-095757) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 0429390) |
| 208000000X Pediatrics (Licence: KS 0429390) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2013-07-02 |