| NPI | 1164578761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: OH 35.122286) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: OH 35) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2015-09-03 |