| NPI | 1548244619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MI 4301039488) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI 4301039488) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2018-07-16 |