| NPI | 1174797062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: OK 27997) |
| Additional Taxonomies | 174400000X Specialist (Licence: OK 27997) |
| 207KA0200X Allergy & Immunology, Allergy (Licence: NC 122355) | |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2016-10-12 |