| NPI | 1619981032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: AZ 16308) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: CA G56837) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2010-01-19 |