| NPI | 1013904622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: ID M6017) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: NV 7241) |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2010-01-20 |