| NPI | 1902888258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: VA 0101030006) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: WV 20325) |
| 207K00000X Allergy & Immunology (Licence: KY 38298) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 38298) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WV 20325) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: VA 0101030006) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TN 50578) | |
| 208000000X Pediatrics (Licence: VA 0101030006) | |
| 208000000X Pediatrics (Licence: KY 38298) | |
| 208000000X Pediatrics (Licence: WV 20325) | |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2020-05-28 |