| NPI | 1487619995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology Allergy (Licence: TX F1545) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: TX F1545) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2017-07-05 |