| NPI | 1861561219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CA G33580) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology Allergy (Licence: CA G33580) |
| 207KI0005X Allergy & Immunology Clinical & Laboratory Immunology (Licence: CA G33580) | |
| 208000000X Pediatrics (Licence: CA G33580) | |
| 2080I0007X Pediatrics Clinical & Laboratory Immunology (Licence: CA G33580) | |
| 2080P0006X Pediatrics Developmental - Behavioral Pediatrics (Licence: CA G33580) | |
| 2080P0201X Pediatrics Pediatric Allergy/Immunology (Licence: CA G33580) | |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2016-03-03 |