| NPI | 1134323363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TX N2441) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX N2441) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2019-04-23 |