| NPI | 1386639425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TN 20604) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN MD20604) |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2012-02-24 |