NPI | 1114923307 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: CA A35393) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA A35393) |
Enumeration Date | 2005-06-22 |
Last Update Date | 2016-04-25 |