| NPI | 1467423855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: MI 5101013420) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 5101013420) |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2020-02-28 |