| NPI | 1245230648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CO 16807) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: CA G32581) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2018-11-16 |