| NPI | 1154543452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: AL 28496) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AL 28496) |
| 208000000X Pediatrics (Licence: AL 28496) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: AL 28496) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2016-03-11 |