| NPI | 1093750796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: VA 0101250699) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: MD D0062974) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2015-11-17 |