| NPI | 1053354456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: CA G30894) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA G30894) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2008-09-16 |