| NPI | 1154716967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: TX T0099) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: TX T0099) |
| 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: TX T0099) | |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2024-09-19 |