| NPI | 1952444788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NE 19195) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: IA 27873) |
| 207KA0200X Allergy & Immunology Allergy (Licence: NE 19195) | |
| 2080P0201X Pediatrics Pediatric Allergy/Immunology (Licence: NE 19195) | |
| 2080P0214X Pediatrics Pediatric Pulmonology (Licence: NE 19195) | |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2007-07-09 |