| NPI | 1801958236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TX M5166) |
| Additional Taxonomies | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: TX M5166) |
| 207KA0200X Allergy & Immunology, Allergy (Licence: TX M5166) | |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2017-05-08 |