| NPI | 1679573588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: CO 43625) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: LA 024632) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2008-07-24 |