| NPI | 1023128592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A55672) |
| Additional Taxonomies | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: CA A55672) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2007-07-09 |