| NPI | 1467616326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: IA 42866) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: OH 35.121205) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2015-09-16 |