| NPI | 1497710735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA G6136) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: CA G6136) |
| 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: CA G6136) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2008-07-22 |