| NPI | 1033296801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MO 2007021701) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036-116788) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2008-01-09 |