| NPI | 1356307490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TN MD10997) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN MD0000010997) |
| 207KA0200X Allergy & Immunology, Allergy (Licence: TN MD10997) | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2018-06-08 |