| NPI | 1376556837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: OR MD13912) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: WA MD00032754) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2007-07-08 |