| NPI | 1720109986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: RI MD04236) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: RI MD04236) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2007-07-08 |