| NPI | 1376516278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: WA MD00047680) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD016805E) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2008-02-22 |