| NPI | 1174502132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: VA 0101240011) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: DC MD036216) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2008-05-28 |