| NPI | 1477535615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: TX T1876) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: FL ME61705) |
| 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: FL ME61705) | |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2023-03-13 |