| NPI | 1447367750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NM 83-322) |
| Additional Taxonomies | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: TX G9233) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2012-07-27 |