| NPI | 1982785234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080I0007X Pediatrics, Clinical & Laboratory Immunology (Licence: WA MD00039283) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD00039283) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2009-02-12 |