NPI | 1124207873 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: LA MD.203242) |
Additional Taxonomies | 208000000X Pediatrics (Licence: LA MD.203242) |
Enumeration Date | 2007-10-30 |
Last Update Date | 2024-02-19 |