NPI | 1619133600 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: CA A125923) |
Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125-052818) |
208000000X Pediatrics (Licence: WI 54495) | |
Enumeration Date | 2008-07-30 |
Last Update Date | 2015-06-17 |