| NPI | 1780727073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NE 19140) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: CO 31486) |
| 207K00000X Allergy & Immunology (Licence: IA 27933) | |
| 207KA0200X Allergy & Immunology, Allergy (Licence: NE 19140) | |
| 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: NE 19140) | |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2007-07-09 |