| NPI | 1053318279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: FL ME0068257) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: FL ME0068257) |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2019-05-24 |