| NPI | 1821023201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: CA G61421) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: CA G61421) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2022-03-02 |