| NPI | 1538372198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: DC MD30062) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101056775) |
| 174400000X Specialist (Licence: MD D0059615) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2014-02-28 |