| NPI | 1982816963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CA C203537) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: HI 13783) |
| 208000000X Pediatrics (Licence: HI 13783) | |
| 207KA0200X Allergy & Immunology, Allergy (Licence: TX V3439) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2026-05-05 |