| NPI | 1306838453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: WV 17504) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: WV 17504) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2018-10-24 |