| NPI | 1326140195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TX G1759) |
| Additional Taxonomies | 207KI0005X Allergy & Immunology, Clinical & Laboratory Immunology (Licence: TX G1759) |
| 208000000X Pediatrics (Licence: TX G1759) | |
| 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: TX G1759) | |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2008-07-21 |