| NPI | 1023037652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology Allergy (Licence: CA C35069) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA C35069) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2007-09-24 |