| NPI | 1154324069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TX D2457) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: CA G130032) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2014-12-26 |