| NPI | 1740237031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CA G32996) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA G32996) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2007-07-09 |