| NPI | 1366655169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: LA MD.026014) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: LA 026014) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2008-11-20 |