| NPI | 1316079676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: PA MD428062) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: DE C1-0007957) |
| 207K00000X Allergy & Immunology (Licence: NJ 25MA08337000) | |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2017-02-07 |