| NPI | 1326211889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NE 26735) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2007016065) |
| 207K00000X Allergy & Immunology (Licence: IA 40242) | |
| 2080P0201X Pediatrics Pediatric Allergy/Immunology (Licence: NE 26735) | |
| 2080P0201X Pediatrics Pediatric Allergy/Immunology (Licence: IA 40242) | |
| Enumeration Date | 2008-04-04 |
| Last Update Date | 2014-02-01 |