| NPI | 1003897851 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CT 025672)  | 
| Additional Taxonomies | 207KI0005X Allergy & Immunology, Clinical & Laboratory Immunology (Licence: CT 025672)  | 
| Enumeration Date | 2005-11-09 | 
| Last Update Date | 2010-02-04 |