| NPI | 1558406066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CT 045087) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: CT 45087) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2016-03-25 |