| NPI | 1538111356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MN 44060) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: TX L6579) |
| 207K00000X Allergy & Immunology (Licence: FL ME107649) | |
| 207RA0201X Internal Medicine, Allergy & Immunology (Licence: TX L6579) | |
| 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: TX L6579) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2020-08-19 |