| NPI | 1700957560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CA G64424) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA G64424) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2011-08-24 |