| NPI | 1669463899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TX G3983) |
| Additional Taxonomies | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: TX G3983) |
| 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: TX G3983) | |
| 2080S0012X Pediatrics, Sleep Medicine (Licence: TX G3983) | |
| 207KI0005X Allergy & Immunology, Clinical & Laboratory Immunology (Licence: TX G3983) | |
| 207KA0200X Allergy & Immunology, Allergy (Licence: TX G3983) | |
| 291U00000X Clinical Medical Laboratory (Licence: TX G3983) | |
| Enumeration Date | 2005-11-05 |
| Last Update Date | 2010-01-14 |