| NPI | 1316035363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CA A80644) |
| Additional Taxonomies | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: CA A80644) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A80644) | |
| 207R00000X Internal Medicine (Licence: CA A80644) | |
| 208000000X Pediatrics (Licence: CA A80644) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2010-09-23 |