| NPI | 1942286331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35-04-6169) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: OH 35-04-6169) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2011-04-04 |