NPI | 1700864881 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NM 2000-219) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NM 2000-219) |
Enumeration Date | 2006-01-09 |
Last Update Date | 2011-09-19 |