| NPI | 1285621573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: FL ME55597) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology Allergy (Licence: FL ME55597) |
| 207KI0005X Allergy & Immunology Clinical & Laboratory Immunology (Licence: FL ME55597) | |
| Enumeration Date | 2005-10-01 |
| Last Update Date | 2007-07-08 |