| NPI | 1356354633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NY 241599) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: TX K5132) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2017-10-10 |