| NPI | 1538311311 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: NC 2000-01425) | 
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: GA 53068) | 
| Enumeration Date | 2008-10-13 | 
| Last Update Date | 2013-02-04 |