| NPI | 1447224852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: FL ME110220) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: PA MD042626E) |
| 207K00000X Allergy & Immunology (Licence: NY 190864-1) | |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2013-06-20 |