| NPI | 1699794222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CA G34844) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA G34844) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2016-03-14 |