| NPI | 1306831045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology Allergy (Licence: ID M2893) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology Allergy (Licence: NV 7424) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2011-11-01 |