| NPI | 1730172339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: IA 30479) |
| Additional Taxonomies | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: IA 30479) |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2012-12-24 |