| NPI | 1003874124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology Allergy (Licence: CA A31444) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A31444) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2010-05-28 |