| NPI | 1134124696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TX E8330) |
| Additional Taxonomies | 207RS0012X Internal Medicine, Sleep Medicine (Licence: TX E8330) |
| 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: TX E8330) | |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2008-02-11 |