| NPI | 1568414985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NM MD2006-0458) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: NM MD2006-0458) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2019-01-30 |