NPI | 1932212255 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: CA G39458) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CO 20232) |
Enumeration Date | 2006-08-17 |
Last Update Date | 2013-02-19 |