| NPI | 1427317130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CT 61840) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NY 273396) |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2019-04-05 |