| NPI | 1972581767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: GA 037463) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: GA 037463) |
| 208000000X Pediatrics (Licence: GA 037463) | |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2011-12-23 |