| NPI | 1508886243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: PA MD029699E) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: PA MD 029699E) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2014-02-07 |