| NPI | 1992770259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: PA MD056503L) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD056503L) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2010-01-26 |