| NPI | 1356390512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: AZ 42305) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: WI 46685-020) |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2011-01-19 |