| 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 |