| NPI | 1366429730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CA A104582) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: MN 46692) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2011-12-02 |