| NPI | 1528062890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: OH 35.039575) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 35039575E) |
| 207K00000X Allergy & Immunology (Licence: OH 35.039575) | |
| Enumeration Date | 2005-06-02 |
| Last Update Date | 2015-07-15 |