| NPI | 1669535886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TX M5931) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology Allergy (Licence: TX M5931) |
| 2080P0201X Pediatrics Pediatric Allergy/Immunology (Licence: TX M5931) | |
| 207RA0201X Internal Medicine Allergy & Immunology (Licence: TX M5931) | |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2009-07-16 |