| NPI | 1861541286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 35883) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: WI 35883) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2017-01-24 |