| NPI | 1184724312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080A0000X Pediatrics Adolescent Medicine (Licence: TN 22468) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology Allergy (Licence: TN 22468) |
| 207Q00000X Family Medicine (Licence: TN 22468) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2022-10-19 |