| NPI | 1124091814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CA 20a6936) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NV 1005) |
| Enumeration Date | 2006-02-11 |
| Last Update Date | 2007-07-08 |