| NPI | 1861468712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: WI 18678) |
| Additional Taxonomies | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: WI 18678) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2017-05-09 |