| NPI | 1851351662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MA 224145) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 224145) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2013-02-25 |