| NPI | 1538144951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NJ 25MA07675400) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: CO 15709) |
| 207KA0200X Allergy & Immunology, Allergy (Licence: WI 14911020) | |
| 207KA0200X Allergy & Immunology, Allergy (Licence: MN 42318) | |
| Enumeration Date | 2005-12-08 |
| Last Update Date | 2016-12-16 |