| NPI | 1770593196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics Pediatric Allergy/Immunology (Licence: CA G39874) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology Allergy (Licence: CA G39874) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2007-07-08 |