| NPI | 1023209491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NC 200600648) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 200600648) |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2009-02-04 |