NPI | 1730100751 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: LA 08142R) |
Additional Taxonomies | 208000000X Pediatrics (Licence: LA 08142R) |
Enumeration Date | 2006-07-23 |
Last Update Date | 2013-04-03 |