| NPI | 1568416345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: KS 19075) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: MO R3B49) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2007-07-08 |