| NPI | 1235174012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology Allergy (Licence: SC 34694) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 55996) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2014-09-12 |