| NPI | 1578657334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology Allergy (Licence: TN 4080) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 231750) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2007-07-08 |