| NPI | 1164482725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: LA MD14915) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: FL ME0092763) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2014-09-22 |