| NPI | 1942305081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: PA MD017816E) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: PA MD017816E) |
| 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: PA MD017816E) | |
| 208000000X Pediatrics (Licence: PA MD017816E) | |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2014-02-19 |