| NPI | 1659529386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: CA C42240) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA C42240) |
| Enumeration Date | 2008-09-06 |
| Last Update Date | 2008-09-06 |