| NPI | 1083779359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA C27394) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: CA C27394) |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2007-07-20 |