| NPI | 1396841169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: WA MD00047649) |
| Additional Taxonomies | 207RA0201X Internal Medicine Allergy & Immunology (Licence: WA MD00047649) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2009-12-28 |