| NPI | 1164400040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0602X Otolaryngology Otolaryngic Allergy (Licence: MA 58069) |
| Additional Taxonomies | 207KI0005X Allergy & Immunology Clinical & Laboratory Immunology (Licence: MA 58069) |
| Enumeration Date | 2006-01-02 |
| Last Update Date | 2017-07-31 |