| NPI | 1841271699 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: CT 027137)  | 
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: CT 027137)  | 
| 207KI0005X Allergy & Immunology, Clinical & Laboratory Immunology (Licence: CT 027137)  | |
| 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: CT 27137)  | |
| Enumeration Date | 2005-11-09 | 
| Last Update Date | 2015-08-25 |