| NPI | 1912989690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TX H9268) |
| Additional Taxonomies | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: TX H9268) |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2016-10-17 |